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1.
Public Health ; 208: 1-8, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35659680

RESUMO

OBJECTIVES: This study aimed to evaluate the magnitude of emotional burden on teaching staff during the SARS-CoV-2 pandemic in a significantly impacted region. In addition, the correlates of emotional burden were analysed to enable the design of targeted interventions. STUDY DESIGN: This study was a cross-sectional survey. METHODS: An electronic survey was administered to the teaching staff at public schools and kindergartens in a specific geographical area. Cross-sectional assessments of pandemic-specific variables were performed using the Pandemic Fatigue Scale, the Depression Anxiety Stress Scale (DASS)-21, the Satisfaction with Life Scale, and the Resilient Coping Scale. DASS-21 results were compared with results from a parallel survey that was representative of the local general population. RESULTS: In total, 3251 teaching staff members participated in the survey. Teachers showed a higher emotional burden for depression, anxiety and stress than the general population during the pandemic. According to a linear regression model, this burden is correlated with the language in which the questionnaires were answered, mistrust towards institutions, specific SARS-CoV-2 anxiety, past infection with SARS-CoV-2, avoidance of information about the pandemic and pandemic fatigue; emotional burden was negatively correlated with measures for life satisfaction, resilience and team atmosphere. Some independent variables were shown to contribute differentially to the variance of depression, anxiety or stress. CONCLUSIONS: Emotional distress during the pandemic among teachers is higher than in the general population and correlates with variables that could, at least in principle, be targeted for specific interventions.


Assuntos
COVID-19 , SARS-CoV-2 , Ansiedade/epidemiologia , Ansiedade/psicologia , COVID-19/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Depressão/psicologia , Fadiga/epidemiologia , Humanos , Pandemias , Instituições Acadêmicas , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia
2.
J Child Orthop ; 13(4): 423-430, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31489050

RESUMO

PURPOSE: The aim of the study was to evaluate the accuracy and radiographic outcomes of Canale's method in patients with idiopathic leg-length discrepancy (LLD) following percutaneous epiphysiodesis. The accuracy of two common growth prediction methods was assessed. METHODS: A total of 18 patients with 26 affected bones (eight distal femur, two proximal tibia, five combined) were clinically and radiologically analyzed after reaching skeletal maturity. We compared the final effect of epiphysiodesis at maturity with the expected effect of epiphysiodesis before surgery; these measures were calculated using the Green-Anderson and multiplier methods, respectively. We furthermore compared pre- and postoperative frontal and lateral plane radiographs. RESULTS: The average LLD was 21.2 mm before surgery and 7.9 mm after epiphysiodesis. The final effect of both methods was not significantly different compared with the expected effect of epiphysiodesis before surgery. However, the prediction by the Green-Anderson method was closer to the definitive epiphysiodesis effect. The frontal plane radiographic deformity parameters did not change significantly after epiphysiodesis. The postoperative sagittal plane radiographic deformity parameters were in the normal range. CONCLUSION: The Canale technique is a reliable method to reduce LLD in children. With regards to growth prediction, the Green-Anderson method using bone age seems to be more accurate than the multiplier method using chronological age. However, a relative over-estimation was observed with both methods in several cases, which might result in an insufficient correction. LEVEL OF EVIDENCE: IV, Therapeutic study.

3.
Diabet Med ; 34(11): 1500-1507, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28626906

RESUMO

As the prevalence of obesity in Type 1 diabetes rises, the effects of emerging therapy options should be considered in the context of both weight and glycaemic control outcomes. Artificial pancreas device systems will 'close the loop' between blood glucose monitoring and automated insulin delivery and may transform day-to-day dietary management for people with Type 1 diabetes in multiple ways. In the present review, we draw directly from cognitive restraint theory to consider unintended impacts that closed-loop systems may have on ingestive behaviour and food intake. We provide a brief overview of dietary restraint theory and its relation to weight status in the general population, discuss the role of restraint in traditional Type 1 diabetes treatment, and lastly, use this restraint framework to discuss the possible behavioural implications and opportunities of closed-loop systems in the treatment of Type 1 diabetes. We hypothesize that adopting closed-loop systems will lift the diligence and restriction that characterizes Type 1 diabetes today, thus requiring a transition from a restrained eating behaviour to a non-restrained eating behaviour. Furthermore, we suggest this transition be leveraged as an opportunity to teach people lifelong eating behaviour to promote healthy weight status by incorporating education and cognitive reappraisal. Our aim was to use a transdisciplinary approach to highlight critical aspects of the emerging closed-loop technologies relating to eating behaviour and weight effects and to promote discussion of strategies to optimize long-term health in Type 1 diabetes via two key outcomes: glycaemic control and weight management.


Assuntos
Cognição/fisiologia , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/tratamento farmacológico , Comportamentos Relacionados com a Saúde/fisiologia , Sistemas de Infusão de Insulina , Insulina/administração & dosagem , Pâncreas Artificial , Automonitorização da Glicemia/instrumentação , Automonitorização da Glicemia/métodos , Diabetes Mellitus Tipo 1/psicologia , Comportamento Alimentar/fisiologia , Comportamento Alimentar/psicologia , Humanos , Modelos Psicológicos , Autocontrole/psicologia
4.
Nervenarzt ; 88(2): 163-172, 2017 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-27999880

RESUMO

BACKGROUND: Frontotemporal lobar degeneration (FTLD) includes a spectrum of heterogeneous clinical and neuropathological diseases. In a strict sense this includes the behavioral variant of frontotemporal dementia (bvFTD) and primary progressive aphasia (PPA) and both variants can be associated with amyotrophic lateral sclerosis (FTD-ALS). In a broader sense FTLD also includes progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS). In recent years the strong genetic component of FTLD has become increasingly clear. OBJECTIVE: The association between clinical presentation, neuropathology, genetics and pathophysiological mechanisms of FTLD are presented. RESULTS: The diagnostic criteria and tools for the clinical differential diagnosis of FTLD are presented. At autopsy patients show neuronal and glial inclusions of Tau, TDP-43 or FUS. While Tau pathology is often associated with extrapyramidal symptoms, patients with TDP-43 and FUS inclusions often also show signs of ALS. Pathogenic mutations directly increase the aggregation propensity of these proteins or impair protein degradation through autophagy or the proteasome. Pathogenic mutations in most FTLD genes trigger cytoplasmic missorting and aggregation of the RNA-binding protein TDP-43 and thus lead to a nuclear loss of TDP-43 function. Microgliosis and mutations in GRN and TREM2 suggest an important role of neuroinflammation in FTLD. CONCLUSION: There is still no causal therapy for FTLD but preclinical studies focusing on pathogenic mutations in C9orf72, GRN and Tau may lead to clinical trials soon; therefore, establishing large well characterized patient cohorts is crucial for trial readiness.


Assuntos
Degeneração Lobar Frontotemporal/epidemiologia , Degeneração Lobar Frontotemporal/genética , Predisposição Genética para Doença/epidemiologia , Predisposição Genética para Doença/genética , Proteínas do Tecido Nervoso/genética , Polimorfismo de Nucleotídeo Único/genética , Idoso , Feminino , Degeneração Lobar Frontotemporal/diagnóstico , Alemanha/epidemiologia , Humanos , Masculino , Mutação/genética , Prevalência , Fatores de Risco
5.
Nervenarzt ; 87(7): 708-18, 2016 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-26391959

RESUMO

BACKGROUND: Dementia impairs the coping with routine daily tasks and social relationships due to an increasing degeneration of cognitive abilities. An appropriate treatment must adequately consider the effects of declined cognitive abilities on patients and their environment. Therefore, in recent times, integrative procedures for cognitive rehabilitation (CR) have become increasingly important for the therapy of patients with mild cognitive impairment (MCI) and mild dementia (MD). CR approaches provide compensatory possibilities for clearly defined routine challenges and the individual needs of those affected. MATERIAL AND METHODS: This overview article in the form of a selective review elaborates factors for the effectiveness of CR on the basis of the currently available literature: 1) individuality - consideration of personal needs and targets, 2) compensation - mediation of skills and strategies to compensate for cognitive impairments, 3) interaction - inclusion of relatives and environmental conditions and 4) integration - integration of various therapeutic disciplines and methods. RESULTS AND DISCUSSION: On the basis of this assessment with regards to the content, a critical analysis of the methods of short and long-term therapeutic effects on MCD and MD was carried out. Although the resulting factors were of high long-term relevance for the improvement of depression and quality of life, effects on cognition were more pronounced for MCI than for MD, which emphasizes the importance of beginning therapy as early as possible. The results show that future studies on effectiveness must employ endpoints relevant for routine daily life, and that the possibility of an implementation of therapeutic concepts in a healthcare system should be considered as an essential criterion.


Assuntos
Doença de Alzheimer/psicologia , Doença de Alzheimer/reabilitação , Terapia Cognitivo-Comportamental/métodos , Disfunção Cognitiva/psicologia , Disfunção Cognitiva/reabilitação , Reabilitação Neurológica/métodos , Medicina Baseada em Evidências , Alemanha , Humanos , Resultado do Tratamento
6.
Osteoporos Int ; 26(7): 1971-7, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25749740

RESUMO

UNLABELLED: Bone mineral density (BMD) measurement can vary depending upon anatomical site, machine, and normative values used. This analysis compared different BMD endpoints in two clinical trials. Trial results differed across endpoints. Future clinical trials should consider inclusion of multiple endpoints in sensitivity analysis to ensure sound overall study conclusions. INTRODUCTION: Methodological issues hamper efficacy assessment of osteoporosis prevention agents in cancer survivors. Osteoporosis diagnosis can vary depending upon which bone mineral density (BMD) anatomical site and machine is used and which set of normative values are applied. This analysis compared different endpoints for osteoporosis treatment efficacy assessment in two clinical studies. METHODS: Data from North Central Cancer Treatment Group phase III clinical trials N02C1 and N03CC (Alliance) were employed involving 774 patients each comparing two treatments for osteoporosis prevention. Endpoints for three anatomical sites included raw BMD score (RawBMD); raw machine-based, sample-standardized, and reference population-standardized T scores (RawT, TSamp, TRef); and standard normal percentile corresponding to the reference population-standardized T score (TPerc). For each, treatment arm comparison was carried out using three statistical tests using change and percentage change from baseline (CB, %CB) at 1 year. RESULTS: Baseline correlations among endpoints ranged from 0.79 to 1.00. RawBMD and TPerc produced more statistically significant results (14 and 19 each out of 36 tests) compared to RawT (11/36), TSamp (8/36), and TRef (7/36). Spine produced the most statistically significant results (26/60) relative to femoral neck (20/60) and total hip (13/60). Lastly, CB resulted in 44 statistically significant results out of 90 tests, whereas %CB resulted in only 15 significant results. CONCLUSIONS: Treatment comparisons and interpretations were different across endpoints and anatomical sites. Transforming via sample statistics provided similar results as transforming via reference or machine-based norms. However, RawBMD and TPerc may be more sensitive to change as clinical trial endpoints.


Assuntos
Conservadores da Densidade Óssea/uso terapêutico , Densidade Óssea/efeitos dos fármacos , Neoplasias da Mama/tratamento farmacológico , Osteoporose Pós-Menopausa/prevenção & controle , Absorciometria de Fóton/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Difosfonatos/uso terapêutico , Método Duplo-Cego , Determinação de Ponto Final , Feminino , Colo do Fêmur/fisiopatologia , Humanos , Imidazóis/uso terapêutico , Vértebras Lombares/fisiopatologia , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/diagnóstico , Osteoporose Pós-Menopausa/fisiopatologia , Reprodutibilidade dos Testes , Ácido Risedrônico/uso terapêutico , Resultado do Tratamento , Ácido Zoledrônico
7.
Unfallchirurg ; 116(4): 367-70, 2013 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-22699319

RESUMO

Intra-articular corticosteroid injection and radiation of the wrist was performed in a patient on immunosuppressive therapy. She sustained empyema and impending compartment syndrome. After fasciotomy, debridement and antibiotic therapy had been performed, we provided soft tissue coverage by a combined ALTP and muscular free flap on the vascular trunk of the descending branch of the lateral circumflex femoral artery. There were no complications and the patient is very satisfied with the outcome.


Assuntos
Corticosteroides/efeitos adversos , Síndromes Compartimentais/induzido quimicamente , Síndromes Compartimentais/cirurgia , Retalho Perfurante/transplante , Procedimentos de Cirurgia Plástica/métodos , Punho/cirurgia , Adulto , Feminino , Humanos , Imunossupressores/efeitos adversos , Resultado do Tratamento
8.
Z Orthop Unfall ; 150(3): 262-8, 2012 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-22426992

RESUMO

BACKGROUND: Idiopathic aseptic osseous necrosis of the semilunar bone is also called Kienböck's disease after Robert Kienböck who firstly described this disease. The clinical picture is characterised by a stage-like course. Internationally the classification according to Lichtman and Ross has achieved the most acceptance. The actual therapy is dependent on the present disease stage. Basically, various pressure-relieving operative procedures are possible, on the other hand operative interventions via revascularisation represent a therapeutic option. In the case of advanced disease only, "salvage procedures" like partial or total arthrodesis of the wrist are available. However, such operations are associated with marked restrictions in the range of motion and unsatisfactory clinical results. The present study reports on our clinical experiences after operative therapy for aseptic lunar bone necrosis via free microvascularised bone grafting from the distal femur. PATIENTS AND METHODS: Between 01/2005 and 12/2010 nineteen patients with idiopathic semilunar bone necrosis underwent operative care via a free microvascularised bone graft from the distal femur at our institution. 16 patients could be re-evaluated retrospectively on follow-up examination at 26.5 months (range 16-42) on average after primary care. Mean age was 43.8 years (range 24-66). Clinical assessment was performed according to the Mayo wrist score (MWS) and the disabilities of the arm, shoulder and hand (DASH) score. Radiological assessment was performed according to the classification of Lichtman and Ross. RESULTS: On operative treatment 14 patients were graded II at least according to the Lichtman classification. An additional 2 patients showed a stage III B disease. The median operative time amounted to 254 min (range 233-362). The postoperative course did not reveal any complications, in particular concerning wound healing. Only one patient (6 %) showed no trabecular integration between the inserted graft and the lunar bone. Clinical evaluation according to the MWS with a median of 82.5 points (65-100), and the DASH score with a median of 29.5 points (24.2-102.2) documented good to excellent clinical results. CONCLUSION: Operative treatment for idiopathic semilunar bone necrosis via a free microvascularised bone graft from distal femur achieves good clinical results without an increase of postoperative complications even with advanced stages of the disease. However, long-term results and larger patient samples are required to prove the final success of this operative technique.


Assuntos
Fêmur/irrigação sanguínea , Fêmur/transplante , Osso Semilunar/cirurgia , Osteonecrose/diagnóstico por imagem , Osteonecrose/cirurgia , Retalhos Cirúrgicos/irrigação sanguínea , Adulto , Idoso , Feminino , Fêmur/diagnóstico por imagem , Humanos , Osso Semilunar/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Radiografia , Resultado do Tratamento , Adulto Jovem
9.
Nervenarzt ; 83(7): 878-87, 2012 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-21713583

RESUMO

BACKGROUND: Cognitive performance depends on intact cortical connectivity. Important for memory processing in the human brain is the connection between posterior cingulate cortex and hippocampus, directly as well as indirectly via the parahippocampal gyrus. These brain areas are involved early in Alzheimer's disease (AD). At the same time, they belong to the default mode network (DMN), a functional network showing high functional connectivity under resting state conditions. In AD, this connectivity in specifically compromised, offering the possibility to investigate the structural basis of functional brain connectivity. METHODS: We studied 18 patients with mild to moderate AD, 16 patients with mild cognitive impairment (MCI) and 20 healthy control subjects using diffusion tensor imaging (DTI) and resting state fMRI at 3.0 Tesla. We determined the effect of structural integrity in the posterior cingulate as assessed by DTI on the functional connectivity between posterior cingulate, hippocampus and parahippocampus during resting state in these three groups. RESULTS: Structural integrity was reduced in posterior cingulate fibre tracts in patients with AD in the left hemisphere; however, this effect was partly accounted for by age differences. All three groups showed high functional connectivity between posterior cingulate cortex and hippocampus, via both the direct and the indirect pathways. Determination of effective connectivity yielded a negative fractional anisotropy (FA)-moderated correlation on the direct pathway in AD and MCI for both hemispheres, and in healthy controls for the right hemisphere. The indirect pathway showed a negative FA-moderated correlation in AD for the right hemisphere and in MCI for both hemispheres. Healthy controls showed a positive correlation on the indirect pathway for the left hemisphere. CONCLUSION: Our data suggest that under healthy conditions, effective connectivity in the DMN between posterior cingulate cortex and hippocampus is mainly maintained by the indirect pathway via the parahippocampal gyrus. Patients with AD and patients with MCI show changes in this connectivity with a partial allocation to the direct pathway, most likely reflecting early parahippocampal lesions. The combination of DTI and fMRI broadens our understanding of human brain connectivity and its pathological changes with AD.


Assuntos
Doença de Alzheimer/patologia , Doença de Alzheimer/fisiopatologia , Encéfalo/patologia , Encéfalo/fisiopatologia , Rede Nervosa/patologia , Rede Nervosa/fisiopatologia , Neuroimagem/métodos , Idoso , Idoso de 80 Anos ou mais , Imagem de Difusão por Ressonância Magnética/métodos , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Vias Neurais/patologia , Vias Neurais/fisiopatologia , Técnica de Subtração
10.
Unfallchirurg ; 115(4): 364-8, 2012 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-21553137

RESUMO

A 20-year-old woman sustained massive elbow trauma from a gunshot wound. After initial surgery soft tissue coverage, reconstruction of the proximal third of the ulna, of the ulnar collateral ligament and of the triceps tendon was performed by one multicomponent microvascular free flap. There were no complications, the elbow is stable and reached full weight bearing 11 months after trauma. Active range of motion for extension and flexion is 0-20°-80°.


Assuntos
Lesões no Cotovelo , Articulação do Cotovelo/cirurgia , Artéria Ilíaca/cirurgia , Traumatismo Múltiplo/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Fraturas da Ulna/cirurgia , Ferimentos por Arma de Fogo/cirurgia , Adulto , Feminino , Humanos , Procedimentos de Cirurgia Plástica/instrumentação , Recuperação de Função Fisiológica , Resultado do Tratamento
11.
IEEE Trans Vis Comput Graph ; 18(12): 2169-77, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26357124

RESUMO

Despite the ongoing efforts in turbulence research, the universal properties of the turbulence small-scale structure and the relationships between small- and large-scale turbulent motions are not yet fully understood. The visually guided exploration of turbulence features, including the interactive selection and simultaneous visualization of multiple features, can further progress our understanding of turbulence. Accomplishing this task for flow fields in which the full turbulence spectrum is well resolved is challenging on desktop computers. This is due to the extreme resolution of such fields, requiring memory and bandwidth capacities going beyond what is currently available. To overcome these limitations, we present a GPU system for feature-based turbulence visualization that works on a compressed flow field representation. We use a wavelet-based compression scheme including run-length and entropy encoding, which can be decoded on the GPU and embedded into brick-based volume ray-casting. This enables a drastic reduction of the data to be streamed from disk to GPU memory. Our system derives turbulence properties directly from the velocity gradient tensor, and it either renders these properties in turn or generates and renders scalar feature volumes. The quality and efficiency of the system is demonstrated in the visualization of two unsteady turbulence simulations, each comprising a spatio-temporal resolution of 10244. On a desktop computer, the system can visualize each time step in 5 seconds, and it achieves about three times this rate for the visualization of a scalar feature volume.

12.
Arq. Inst. Biol. (Online) ; 78(1): 129-136, jan-mar, 2011. tab
Artigo em Português | LILACS, VETINDEX | ID: biblio-1396452

RESUMO

O leite integral e a bebida láctea UAT são submetidos ao mesmo tratamento térmico, mas são produtos diferentes, já que na bebida láctea é permitida a adição de até 50% de soro lácteo. Neste estudo, objetivou-se avaliar as características microbiológicas destes produtos com relação à legislação vigente do Ministério da Agricultura, Pecuária e Abastecimento (MAPA) e, ainda, da população psicrotrófica, ao longo do período de validade. Foram analisadas 150 amostras, 75 de cada produto, a partir de cinco diferentes marcas comerciais nacionais. As 15 amostras de cada marca foram subdivididas em três lotes: início, meio e final do período de validade, cada qual com cinco amostras do mesmo lote. Verificou-se para o leite que todas as amostras de leite UAT estavam de acordo com a legislação vigente. A população de psicrotróficos aumentou em 26,6% das amostras depois que foram abertas e mantidas sob refrigeração por 48 horas. Os resultados para a bebida láctea evidenciaram que 12% das amostras estavam em desacordo com o estabelecido pela legislação vigente. A população de psicrotróficos aumentou em 36% das amostras depois que foram abertas e mantidas sob refrigeração por 48 horas. Tais resultados devem servir de alerta para a necessidade de fiscalização mais rigorosa da bebida láctea UAT, pois parte das amostras não atenderam aos padrões microbiológicos estabelecidos pela legislação.


UHT milk and dairy drinks are submitted to the same heat treatment, but they are different products, since the addition of up to 50% of whey is allowed in dairy drinks. The aim of this study was to evaluate the microbiological characteristics of these products in relation to current legislation, during the course of their shelf life. In the present study, 150 samples, 75 of each type of product, from 5 different national brands were analyzed. The 15 samples of each brand were separated into 3 lots containing 5 samples each, analyzed at the beginning, middle and end of the validity period. Upon microbiological analysis all UHT milk samples were in conformance with current legislation. After the samples were opened and chilled for 48 hours, 26.6% of them presented an increased psychrotrophic population. The dairy drink results showed that 12% of the samples were out of conformance with the current legislation. After the samples were opened and chilled for 48 hours, 36% of them presented an increased psychrotrophic population. These results should be considered as an alert in regard to the need for rigorous inspection of UHT milk and dairy drink products.


Assuntos
Alimentos Integrais , Leite/microbiologia , Tecnologia de Alimentos/métodos , Técnicas Bacteriológicas/métodos
13.
Exp Neurol ; 223(2): 366-70, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19664622

RESUMO

We measured concentrations of Abeta peptides 1-42 and 1-40, and their ratio in plasma of patients carefully categorized clinically and neurochemically as having AD or other dementias with a newly commercially available multiplexing assay, characterized by reasonable laboratory performance (intra-assay imprecision in the range of 1.3-3.8% for Abeta1-42, and 1.8-4.1% for Abeta1-40, inter-assay imprecision for Abeta1-42, Abeta1-40, and Abeta1-42/Abeta1-40 concentration ratio in the range of 2.3-11.5%, 2.2-10.4% and 4.2-9.7%, respectively). Patients with AD or mild cognitive impairment of AD type (MCI-AD) whose clinical diagnosis was supported with CSF biomarkers (n=193) had significantly lower Abeta1-42 plasma concentrations (p<0.007), and Abeta1-42/1-40 ratios (p<0.003) compared to patients with other dementias and MCI of other types (n=64). No significant differences between persons with MCI of AD type and patients with early AD were observed, or between MCI of other types versus patients with early dementia of other types. Our findings reconfirm the hypothesis that alterations of biomarker concentrations occur early in a preclinical AD stage and that these alterations are also reflected in plasma.


Assuntos
Doença de Alzheimer/diagnóstico , Peptídeos beta-Amiloides/sangue , Biomarcadores/sangue , Imunoensaio/métodos , Fragmentos de Peptídeos/sangue , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/sangue , Doença de Alzheimer/líquido cefalorraquidiano , Peptídeos beta-Amiloides/líquido cefalorraquidiano , Biomarcadores/líquido cefalorraquidiano , Demência/sangue , Demência/líquido cefalorraquidiano , Demência/diagnóstico , Diagnóstico Precoce , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fragmentos de Peptídeos/líquido cefalorraquidiano , Valor Preditivo dos Testes
14.
Mol Psychiatry ; 15(2): 138-45, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18663368

RESUMO

In this report, we present the results of a multicenter study to test analytic and diagnostic performance of soluble forms of amyloid precursor proteins alpha and beta (sAPP alpha and sAPP beta) in the cerebrospinal fluid (CSF) of patients with different forms of dementing conditions. CSF samples were collected from 188 patients with early dementia (mini-mental state examination >or=20 in majority of cases) and mild cognitive impairment (MCI) in 12 gerontopsychiatric centers, and the clinical diagnoses were supported by neurochemical dementia diagnostic (NDD) tools: CSF amyloid beta peptides, Tau and phospho-Tau. sAPP alpha and sAPP beta were measured with multiplexing method based on electrochemiluminescence. sAPP alpha and sAPP beta CSF concentrations correlated with each other with very high correlation ratio (R=0.96, P<0.001). We observed highly significantly increased sAPP alpha and sAPP beta CSF concentrations in patients with NDD characteristic for Alzheimer's disease (AD) compared to those with NDD negative results. sAPP alpha and sAPP beta highly significantly separated patients with AD, whose diagnosis was supported by NDD findings (sAPP alpha: cutoff, 117.4 ng ml(-1), sensitivity, 68%, specificity, 85%, P<0.001; sAPP beta: cutoff, 181.8 ng ml(-1), sensitivity, 75%, specificity, 85%, P<0.001), from the patients clinically assessed as having other dementias and supported by NDD untypical for AD. We conclude sAPP alpha and sAPP beta might be regarded as novel promising biomarkers supporting the clinical diagnosis of AD.


Assuntos
Doença de Alzheimer/líquido cefalorraquidiano , Precursor de Proteína beta-Amiloide/líquido cefalorraquidiano , Idoso , Idoso de 80 Anos ou mais , Peptídeos beta-Amiloides/líquido cefalorraquidiano , Biomarcadores/líquido cefalorraquidiano , Transtornos Cognitivos/líquido cefalorraquidiano , Demência/líquido cefalorraquidiano , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Sensibilidade e Especificidade , Estatística como Assunto , Proteínas tau/líquido cefalorraquidiano
15.
Nervenarzt ; 80(3): 273-87, 2009 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-19229510

RESUMO

At present more than 1 million patients in Germany suffer from Alzheimer's disease (AD). This number is expected to double by 2050. The effectiveness of presently approved specific antidementive drugs for symptomatic treatment of AD is still not satisfactory. The question arises whether cognition-based nonpharmacologic measures may constitute an effective intervention in AD and its prodromal stages. The paper at hand defines theoretical general principles of cognitive training and gives an overview of recent findings that provide evidence of its effectiveness. We finally present recommendations for future studies and establishment of cognitive training.


Assuntos
Doença de Alzheimer/diagnóstico , Doença de Alzheimer/reabilitação , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/reabilitação , Terapia Cognitivo-Comportamental/tendências , Doença de Alzheimer/complicações , Transtornos Cognitivos/etiologia , Alemanha , Humanos
16.
Handchir Mikrochir Plast Chir ; 41(1): 44-51, 2009 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-19085822

RESUMO

Successful treatment of scaphoid non-union with avascular necrosis of the proximal poles and humpback deformity with carpal collapse is one of the main problems in reconstructive hand surgery. Vascularised bone transfer is one of the most successful techniques for treating these problems. 15 patients with avascular necrosis and non-union of the scaphoid were treated by a microvascular reanastomosed corticocancellous transplant from the distal medial femur. In all patients the success of the microvascular bone transfer was examined by MRI and conventional radiographs immediately, 6 weeks, 3, 6 and 12 months postoperatively. The transplant vitality, signs of reunion and carpal configuration were registered. Furthermore, the Mayo wrist score was employed for clinical evaluation. All transplants remained vital during the follow-up period of one year. Pseudoarthrosis was treated successfully in every case. In 14 cases there was a significant increase of the Mayo wrist score and in one case there was no difference before and after surgery. The microvascular transfer of corticocancellous femur resulted in a high rate of complete healing of scaphoid pseudoarthrosis and correction of the carpal relation.


Assuntos
Transplante Ósseo/métodos , Microcirurgia/métodos , Osteonecrose/cirurgia , Pseudoartrose/cirurgia , Osso Escafoide/lesões , Osso Escafoide/cirurgia , Adolescente , Adulto , Idoso , Parafusos Ósseos , Feminino , Seguimentos , Fixação Interna de Fraturas , Consolidação da Fratura/fisiologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Osteonecrose/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/cirurgia , Estudos Prospectivos , Pseudoartrose/diagnóstico , Reoperação , Osso Escafoide/patologia , Tomografia Computadorizada por Raios X , Adulto Jovem
17.
Nervenarzt ; 78(11): 1310-8, 2007 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-17611728

RESUMO

In order to improve diagnosis of Alzheimer's disease (AD), candidate biological markers in CSF as well as structural and functional imaging were investigated. Biomarkers are clearly needed to support detection of incipient AD in subjects with mild cognitive impairment (MCI). To date the most promising core candidate markers are total and hyperphosphorylated tau protein and amyloid beta peptides in the CSF, as well as hippocampus and whole brain volumetry using MRI. None of the candidates has been finally validated and established for clinical routine so far. International controlled multicenter cooperative studies are ongoing to further develop these core diagnostic marker candidates (phase III). The core markers are reviewed in detail. Promising novel approaches are discussed.


Assuntos
Doença de Alzheimer/líquido cefalorraquidiano , Doença de Alzheimer/diagnóstico , Encéfalo/metabolismo , Técnicas de Sonda Molecular/tendências , Proteínas do Tecido Nervoso/líquido cefalorraquidiano , Neurobiologia/tendências , Biomarcadores/líquido cefalorraquidiano , Humanos , Prognóstico
18.
Anaesthesia ; 61(11): 1105-8, 2006 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17042851

RESUMO

A 66-year-old patient scheduled for elective shoulder surgery underwent a brachial plexus block using the posterior approach. Shortly after injection of the local anaesthetic, he rapidly became unresponsive and apnoeic. We identify the possible reasons for this occurrence and discuss the place of the posterior approach in brachial plexus anaesthesia.


Assuntos
Raquianestesia/métodos , Plexo Braquial , Bloqueio Nervoso/métodos , Idoso , Anestésicos Locais/efeitos adversos , Apneia/induzido quimicamente , Artroplastia de Substituição/métodos , Bupivacaína/efeitos adversos , Bupivacaína/análogos & derivados , Humanos , Levobupivacaína , Masculino , Articulação do Ombro/cirurgia
19.
Res Vet Sci ; 81(3): 340-4, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16701750

RESUMO

The present study was carried out to report the occurrence Salmonella spp., Salmonella Enteritidis, and Salmonella Typhimurium in chicken abattoirs. Samples of feces; feathers; scald, evisceration, and chiller water; and rinse water of non-eviscerated, eviscerated, and chilled carcass were collected from six chicken abattoirs. Salmonella isolates were identified by a multiplex-PCR using three sets of primers targeting the invA, pefA, and sefA gene sequences from Salmonella spp., S. Typhimurium and S. Enteritidis, respectively. Salmonella spp. was detected in 10% (29/288) of the samples, whereas serovars Enteritidis and Typhimurium were identified in 62% (7/288), respectively. The results indicate the need to improve hygiene and sanitary standards in poultry slaughter lines, besides the education of food handlers and information to consumers.


Assuntos
Matadouros/normas , Galinhas/microbiologia , Reação em Cadeia da Polimerase/veterinária , Salmonella/isolamento & purificação , Animais , Reação em Cadeia da Polimerase/métodos
20.
Amino Acids ; 31(1): 55-62, 2006 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-16715413

RESUMO

5-Benzyloxy-4-trifluoromethyl-1,3-oxazoles, obtained from 5-fluoro-4-trifluoromethyloxazoles and benzyl alcohols, are capable for rearrangements. A 1,3 shift of a benzyl group is the key step of a new general route toward alpha-trifluoromethyl substituted aromatic and heteroaromatic amino acids, demonstrating that 5-fluoro-4-trifluoromethyl-1,3-oxazole is a synthetic Tfm-Gly equivalent. On reaction with benzpinacol partially fluorinated oxazoles are transformed into bis(trifluoromethyl) substituted 2,5-diamino adipic acid and N-benzoyl-2-benzhydryl-3,3,3-trifluoroalanine.


Assuntos
Aminoácidos/síntese química , Compostos Ferrosos/química , Hidrocarbonetos Aromáticos/química , Hidrocarbonetos Fluorados/química , Aminoácidos/química , Metalocenos , Estrutura Molecular , Estereoisomerismo
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